One area where overuse is common is in testing or screening tests. ACP published a consensus that named 37 commonly overused diagnostic procedures and treatments. You may be surprised about what they are and here are a few:
- Annual lipid screening for patients not receiving lipid-lowing drugs or diet therapy
- Screening low risk people for Hepatitis B (If you don't have unsafe sex or use IV drugs you are not at risk)
- Screening for colorectal cancer in adults older than 75 or with a life expectancy of less than 10 years (Yes, lots of doctors do colonoscopies on demented folks in a nursing home or 85 year olds)
- Ordering chest Xrays for hospital patients who are being discharged home and making a good recovery. (These radiographs give no information at all)
- Ordering annual electrocardiograms or other cardiac screening for asymptomatic low risk patients.
- Doing pap tests on patients younger than 21 years or in women who have had a hysterectomy for benign disease.
- Ordering antibiotics for moderate sinusitis unless symptoms last for more than 7 days. (Stuffy, runny nose is not a symptom to be treated)
And what is with prime-time ads for a disease that only affects about 1 million people? We are one of the only countries that allows these direct-to-consumer pharmaceutical ads on TV and in magazines. Other countries have found that this type of advertising brings no value to patients or to society.
(People with RA: No need to write me. I am not against treatment for this terrible disease and it may be that these overpriced medications actually do bring great value. I just want to make sure the right drugs are going to the right patients)